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Haider MN, Regan D, Hoque M, Ali F, Ilowitz A. Effects of recent cannabis consumption on eye-tracking and pupillometry. Front Neurosci 2024; 18:1358491. [PMID: 38655106 PMCID: PMC11036868 DOI: 10.3389/fnins.2024.1358491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Cannabis consumption is known to immediately affect ocular and oculomotor function, however, cannabis consumption is also known to affect it for a prolonged period of time. The purpose of this study is to identify an eye tracking or pupillometry metric which is affected after recent cannabis consumption but is not confounded by cannabis consumption history or demographic variables. Methods Quasi-experimental design. Participants who would consume inhalable cannabis (n = 159, mean age 31.0 years, 54% male) performed baseline neurobehavioral testing and eye-function assessments when they were sober. Eye function assessments included eye-tracking [gaze (point of visual focus), saccades (smooth movement)] and pupillometry. Participants then inhaled cannabis until they self-reported to be high and performed the same assessment again. Controls who were cannabis naïve or infrequent users (n = 30, mean age 32.6 years, 57% male) performed the same assessments without consuming cannabis in between. Results Cannabis significantly affected several metrics of pupil dynamics and gaze. Pupil size variability was the most discriminant variable after cannabis consumption. This variable did not change in controls on repeat assessment (i.e., no learning effect), did not correlate with age, gender, race/ethnicity, or self-reported level of euphoria, but did correlate with THC concentration of cannabis inhaled. Discussion A novel eye-tracking metric was identified that is affected by recent cannabis consumption and is not different from non-users at baseline. A future study that assesses pupil size variability at multiple intervals over several hours and quantifies cannabis metabolites in biofluids should be performed to identify when this variable normalizes after consumption and if it correlates with blood THC levels.
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Affiliation(s)
- Mohammad N. Haider
- Department of Orthopedics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United States
- University Concussion Management Clinic and Research Center, UBMD Orthopedics and Sports Medicine, Buffalo, NY, United States
| | - Daniel Regan
- University Concussion Management Clinic and Research Center, UBMD Orthopedics and Sports Medicine, Buffalo, NY, United States
| | - Mahamudul Hoque
- Department of Biological Sciences, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United States
| | - Fahed Ali
- University Concussion Management Clinic and Research Center, UBMD Orthopedics and Sports Medicine, Buffalo, NY, United States
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Howard ME, Cori JM. Time for sleep science to wake up to drowsy driver monitoring. Sleep 2024; 47:zsad324. [PMID: 38147022 PMCID: PMC10851863 DOI: 10.1093/sleep/zsad324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Indexed: 12/27/2023] Open
Affiliation(s)
- Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
- Department of Medicine, University of Melbourne, Parkville, VIC, Australia
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Jennifer M Cori
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
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Rosekind MR, Michael JP, Dorey-Stein ZL, Watson NF. Awake at the wheel: how auto technology innovations present ongoing sleep challenges and new safety opportunities. Sleep 2024; 47:zsad316. [PMID: 38109232 DOI: 10.1093/sleep/zsad316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/29/2023] [Indexed: 12/20/2023] Open
Abstract
Individuals and society are dependent on transportation. Individuals move about their world for work, school, healthcare, social activities, religious and athletic events, and so much more. Society requires the movement of goods, food, medicine, etc. for basic needs, commerce, cultural and political exchanges, and all of its dynamic, complex elements. To meet these critical daily demands, the transportation system operates globally and around the clock. Regardless of their role, a basic requirement for the individuals operating the transportation system is that they are awake and at optimal alertness. This applies to individuals driving their own cars, riding a bike or motorcycle, as well as pilots of commercial aircraft, train engineers, long-haul truck drivers, and air traffic controllers. Alert operators are a basic requirement for a safe and effective transportation system. Decades of scientific and operational research have demonstrated that the 24/7 scheduling demands on operators and passengers of our transportation system create sleep and circadian disruptions that reduce alertness and performance and cause serious safety problems. These challenges underly the longstanding interest in transportation safety by the sleep and circadian scientific community. An area currently offering perhaps the most significant opportunities and challenges in transportation safety involves vehicle technology innovations. This paper provides an overview of these latest innovations with a focus on sleep-relevant issues and opportunities. Drowsy driving is discussed, along with fatigue management in round-the-clock transportation operations. Examples of cases where technology innovations could improve or complicate sleep issues are discussed, and ongoing sleep challenges and new safety opportunities are considered.
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Affiliation(s)
| | - Jeffrey P Michael
- Johns Hopkins University, School of Public Health, Baltimore, MD, USA
| | | | - Nathaniel F Watson
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
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Giorgi A, Ronca V, Vozzi A, Aricò P, Borghini G, Capotorto R, Tamborra L, Simonetti I, Sportiello S, Petrelli M, Polidori C, Varga R, van Gasteren M, Barua A, Ahmed MU, Babiloni F, Di Flumeri G. Neurophysiological mental fatigue assessment for developing user-centered Artificial Intelligence as a solution for autonomous driving. Front Neurorobot 2023; 17:1240933. [PMID: 38107403 PMCID: PMC10721973 DOI: 10.3389/fnbot.2023.1240933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/18/2023] [Indexed: 12/19/2023] Open
Abstract
The human factor plays a key role in the automotive field since most accidents are due to drivers' unsafe and risky behaviors. The industry is now pursuing two main solutions to deal with this concern: in the short term, there is the development of systems monitoring drivers' psychophysical states, such as inattention and fatigue, and in the medium-long term, there is the development of fully autonomous driving. This second solution is promoted by recent technological progress in terms of Artificial Intelligence and sensing systems aimed at making vehicles more and more accurately aware of their "surroundings." However, even with an autonomous vehicle, the driver should be able to take control of the vehicle when needed, especially during the current transition from the lower (SAE < 3) to the highest level (SAE = 5) of autonomous driving. In this scenario, the vehicle has to be aware not only of its "surroundings" but also of the driver's psychophysical state, i.e., a user-centered Artificial Intelligence. The neurophysiological approach is one the most effective in detecting improper mental states. This is particularly true if considering that the more automatic the driving will be, the less available the vehicular data related to the driver's driving style. The present study aimed at employing a holistic approach, considering simultaneously several neurophysiological parameters, in particular, electroencephalographic, electrooculographic, photopletismographic, and electrodermal activity data to assess the driver's mental fatigue in real time and to detect the onset of fatigue increasing. This would ideally work as an information/trigger channel for the vehicle AI. In all, 26 professional drivers were engaged in a 45-min-lasting realistic driving task in simulated conditions, during which the previously listed biosignals were recorded. Behavioral (reaction times) and subjective measures were also collected to validate the experimental design and to support the neurophysiological results discussion. Results showed that the most sensitive and timely parameters were those related to brain activity. To a lesser extent, those related to ocular parameters were also sensitive to the onset of mental fatigue, but with a delayed effect. The other investigated parameters did not significantly change during the experimental session.
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Affiliation(s)
- Andrea Giorgi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
- BrainSigns SRL, Rome, Italy
| | - Vincenzo Ronca
- BrainSigns SRL, Rome, Italy
- Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Rome, Italy
| | - Alessia Vozzi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
- BrainSigns SRL, Rome, Italy
| | - Pietro Aricò
- BrainSigns SRL, Rome, Italy
- Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Rome, Italy
| | - Gianluca Borghini
- BrainSigns SRL, Rome, Italy
- Laboratory of Industrial Neuroscience, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Rossella Capotorto
- Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Rome, Italy
- Laboratory of Industrial Neuroscience, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Luca Tamborra
- BrainSigns SRL, Rome, Italy
- Laboratory of Industrial Neuroscience, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Ilaria Simonetti
- BrainSigns SRL, Rome, Italy
- Laboratory of Industrial Neuroscience, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Simone Sportiello
- Department of Civil Engineering, Computer Science and Aeronautical Technologies, Roma Tre University, Rome, Italy
- Department of Enterprise Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Marco Petrelli
- Department of Civil Engineering, Computer Science and Aeronautical Technologies, Roma Tre University, Rome, Italy
| | - Carlo Polidori
- Italian Association of Road Safety Professionals (AIPSS), Rome, Italy
| | - Rodrigo Varga
- Instituto Tecnologico de Castilla y Leon, Burgos, Spain
| | | | - Arnab Barua
- Academy for Innovation, Design and Technology, Mälardalens University, Västerås, Sweden
| | - Mobyen Uddin Ahmed
- Academy for Innovation, Design and Technology, Mälardalens University, Västerås, Sweden
| | - Fabio Babiloni
- BrainSigns SRL, Rome, Italy
- Laboratory of Industrial Neuroscience, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
- College of Computer Science and Technology, Hangzhou Dianzi University, Hangzhou, China
| | - Gianluca Di Flumeri
- BrainSigns SRL, Rome, Italy
- Laboratory of Industrial Neuroscience, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Anderson C, Cai AWT, Lee ML, Horrey WJ, Liang Y, O’Brien CS, Czeisler CA, Howard ME. Feeling sleepy? stop driving-awareness of fall asleep crashes. Sleep 2023; 46:zsad136. [PMID: 37158173 PMCID: PMC10636256 DOI: 10.1093/sleep/zsad136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 04/04/2023] [Indexed: 05/10/2023] Open
Abstract
STUDY OBJECTIVES To examine whether drivers are aware of sleepiness and associated symptoms, and how subjective reports predict driving impairment and physiological drowsiness. METHODS Sixteen shift workers (19-65 years; 9 women) drove an instrumented vehicle for 2 hours on a closed-loop track after a night of sleep and a night of work. Subjective sleepiness/symptoms were rated every 15 minutes. Severe and moderate driving impairment was defined by emergency brake maneuvers and lane deviations, respectively. Physiological drowsiness was defined by eye closures (Johns drowsiness scores) and EEG-based microsleep events. RESULTS All subjective ratings increased post night-shift (p < 0.001). No severe drive events occurred without noticeable symptoms beforehand. All subjective sleepiness ratings, and specific symptoms, predicted a severe (emergency brake) driving event occurring in the next 15 minutes (OR: 1.76-2.4, AUC > 0.81, p < 0.009), except "head dropping down". Karolinska Sleepiness Scale (KSS), ocular symptoms, difficulty keeping to center of the road, and nodding off to sleep, were associated with a lane deviation in the next 15 minutes (OR: 1.17-1.24, p<0.029), although accuracy was only "fair" (AUC 0.59-0.65). All sleepiness ratings predicted severe ocular-based drowsiness (OR: 1.30-2.81, p < 0.001), with very good-to-excellent accuracy (AUC > 0.8), while moderate ocular-based drowsiness was predicted with fair-to-good accuracy (AUC > 0.62). KSS, likelihood of falling asleep, ocular symptoms, and "nodding off" predicted microsleep events, with fair-to-good accuracy (AUC 0.65-0.73). CONCLUSIONS Drivers are aware of sleepiness, and many self-reported sleepiness symptoms predicted subsequent driving impairment/physiological drowsiness. Drivers should self-assess a wide range of sleepiness symptoms and stop driving when these occur to reduce the escalating risk of road crashes due to drowsiness.
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Affiliation(s)
- Clare Anderson
- Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Anna W T Cai
- Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Michael L Lee
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - William J Horrey
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- AAA Foundation for Traffic Safety, Washington, DC, USA
| | - Yulan Liang
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
| | - Conor S O’Brien
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Center for Innovation in Digital Healthcare, Mass General Hospital, Boston MA, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Mark E Howard
- Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC,Australia
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Aitken B, Hayley AC, Ford TC, Geier L, Shiferaw BA, Downey LA. Driving impairment and altered ocular activity under the effects of alprazolam and alcohol: A randomized, double-blind, placebo-controlled study. Drug Alcohol Depend 2023; 251:110919. [PMID: 37611483 DOI: 10.1016/j.drugalcdep.2023.110919] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/03/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Alprazolam, also known by trade-name Xanax, is regularly detected along with alcohol in blood samples of drivers injured or killed in traffic collisions. While their co-consumption is principally legal, policy guidelines concerning fitness-to-drive are lacking and methods to index impairment are underdeveloped. METHODS In this randomized, double-blind, placebo-controlled, crossover trial, we examined whether legally permissible levels of alcohol [target 0.04% blood alcohol concentration (BAC)], alprazolam (1mg), and their combination impacts driving performance, and whether driving impairment can be indexed by ocular activity. Participants completed a test battery consisting of a 40-minute simulated highway drive with ocular parameters assessed simultaneously, the Karolinska Sleepiness Scale, and a confidence to drive assessment following four separate treatment combinations. The predictive efficacy of ocular parameters to identify alcohol and alprazolam-related driving impairment was also examined. RESULTS Among 21 healthy, fully licensed drivers (37% female, mean age 28.43, SD ± 3.96), driving performance was significantly impacted by alprazolam, alcohol, and their combination. Linear regression models revealed that the odds of an out-of-lane event occurring increased five-fold under the influence alprazolam alone and when combined with alcohol. An increase in gaze transition entropy (GTE) demonstrated the strongest association with the odds of an out-of-lane event occurring in the same minute, with both microsleeps and fixation rate achieving moderate accuracy across treatments. CONCLUSIONS Alprazolam and alcohol, alone and in combination, impaired select aspects of vehicle control over time. GTE, microsleeps, and fixation rate show potential as real-time indicators of driving impairment and crash risk associated with alcohol and alprazolam consumption.
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Affiliation(s)
- Blair Aitken
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Amie C Hayley
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia; Institute for Breathing and Sleep (IBAS), Austin Hospital, Heidelberg, Victoria, Australia
| | - Talitha C Ford
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia; Cognitive Neuroscience Unit, Deakin University, Geelong, Victoria, Australia
| | - Lauren Geier
- Forensic Science South Australia, Adelaide, Australia
| | - Brook A Shiferaw
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia; Institute for Breathing and Sleep (IBAS), Austin Hospital, Heidelberg, Victoria, Australia; Seeing Machines, Fyshwick, Australian Capital Territory (ACT), Australia
| | - Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia; Institute for Breathing and Sleep (IBAS), Austin Hospital, Heidelberg, Victoria, Australia.
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Cori JM, Wilkinson VE, Jackson M, Westlake J, Stevens B, Barnes M, Swann P, Howard ME. The impact of alcohol consumption on commercial eye blink drowsiness detection technology. Hum Psychopharmacol 2023:e2870. [PMID: 37291082 DOI: 10.1002/hup.2870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/20/2023] [Accepted: 04/17/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Driver drowsiness detection technology that assesses eye blinks is increasingly being used as a safety intervention in the transport industry. It is unclear how alcohol consumption to common legal driving limits impacts upon this technology. The aim of the study was to assess the impact of a blood alcohol content (BAC) of 0.05% and of 0.08% on drowsiness detection technology during simulated driving. METHODS Participants completed a 60-min driving simulation and sleepiness questionnaire under three conditions: 1-0.00% BAC, 2-0.05% BAC and 3-0.08% BAC. During the driving simulation task participants wore a commercial eye blink drowsiness detection technology (Optalert) with the drowsiness alarms silenced. RESULTS Twelve participants (3 female) completed all alcohol conditions. Relative to baseline, all eye blink parameters were affected at 0.08% BAC (all p < 0.05), whereas 0.05% BAC only affected the composite eye blink drowsiness measure (the Johns Drowsiness Scale). CONCLUSIONS Alcohol consumption to 0.08% BAC impaired eye blink measures to a level that would be considered a moderate drowsiness risk. Therefore, employers should be aware that drowsiness alerts from these technologies may increase after alcohol consumption.
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Affiliation(s)
- Jennifer M Cori
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Vanessa E Wilkinson
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Melinda Jackson
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Justine Westlake
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Bronwyn Stevens
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Maree Barnes
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Philip Swann
- Psychology Unit, Faculty of Medicine Nursing and Health Science, Monash University, Clayton, Victoria, Australia
| | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
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Chen Y, Sudin ES, Partridge GJW, Taib AG, Darker IT, Phillips P, James JJ, Satchithananda K, Sharma N, Michell MJ. Measuring reader fatigue in the interpretation of screening digital breast tomosynthesis (DBT). Br J Radiol 2023; 96:20220629. [PMID: 36633316 PMCID: PMC9975365 DOI: 10.1259/bjr.20220629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/01/2022] [Accepted: 11/06/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES The interpretation of digital breast tomosynthesis (DBT) screening examinations is a complex task for an already overstretched workforce which has the potential to increase pressure on readers leading to fatigue and patient safety issues. Studies in non-medical and medical settings have suggested that changes in blink characteristics can reflect fatigue. The purpose of this study is to investigate the use of blink characteristics as an objective marker of fatigue in readers interpreting DBT breast screening examinations. METHODS Twenty-six DBT readers involved in the UK PROSPECTS trial interpreted a test set of 40 DBT cases while being observed by an eye tracking device from November 2019 to February 2021. Raw data from the eye tracker were collected and automated processing software was used to produce eye blinking characteristics data which were analysed using multiple linear regression statistical models. RESULTS Of the 26 DBT readers recruited, eye tracking data from 23 participants were analysed due to missing data rendering 3 participants' data uninterpretable. The mean reading time per DBT case was 2.81 min. There was a statistically significant increase in blinking duration of 0.38 ms/case as the reading session progressed (p < 0.0001). This was the result of a significant decrease in the number of ultra-short blinks lasting ≤50 ms (p = 0.0005) and a significant increase in longer blinks lasting 51-100 ms (p = 0.008). CONCLUSION Changes in blinking characteristics could serve as objective measures of reader fatigue and may prove useful in the development of DBT reading protocols. ADVANCES IN KNOWLEDGE Blink characteristics can be used as an objective measure of fatigue; however there is limited evidence of their use in radiological settings. Our study suggests that changes in blink duration and frequency could be used to monitor fatigue in DBT reading sessions.
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Affiliation(s)
- Yan Chen
- University of Nottingham, School of Medicine, Translational Medical Sciences, Clinical Sciences Building, City Hospital Campus, Hucknall Road, Nottingham, United Kingdom
| | - Ellhia S Sudin
- University of Nottingham, School of Medicine, Translational Medical Sciences, Clinical Sciences Building, City Hospital Campus, Hucknall Road, Nottingham, United Kingdom
| | - George JW Partridge
- University of Nottingham, School of Medicine, Translational Medical Sciences, Clinical Sciences Building, City Hospital Campus, Hucknall Road, Nottingham, United Kingdom
| | - Adnan G Taib
- University of Nottingham, School of Medicine, Translational Medical Sciences, Clinical Sciences Building, City Hospital Campus, Hucknall Road, Nottingham, United Kingdom
| | - Iain T Darker
- University of Nottingham, School of Medicine, Translational Medical Sciences, Clinical Sciences Building, City Hospital Campus, Hucknall Road, Nottingham, United Kingdom
| | - Peter Phillips
- Health and Medical Sciences Group, University of Cumbria, Lancaster, United Kingdom
| | - Jonathan J James
- Nottingham University Hospitals NHS Trust, Nottingham Breast Institute, City Hospital Campus, Hucknall Road, Nottingham, United Kingdom
| | - Keshthra Satchithananda
- Department of Breast Radiology, National Breast Screening Training Centre, King’s College Hospital, Denmark Hill, London, United Kingdom
| | - Nisha Sharma
- Leeds Breast Screening Unit, Leeds Teaching Hospital, York Road, Leeds, United Kingdom
| | - Michael J Michell
- Department of Breast Radiology, National Breast Screening Training Centre, King’s College Hospital, Denmark Hill, London, United Kingdom
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Sprajcer M, Dawson D, Kosmadopoulos A, Sach EJ, Crowther ME, Sargent C, Roach GD. How Tired is Too Tired to Drive? A Systematic Review Assessing the Use of Prior Sleep Duration to Detect Driving Impairment. Nat Sci Sleep 2023; 15:175-206. [PMID: 37038440 PMCID: PMC10082604 DOI: 10.2147/nss.s392441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/03/2023] [Indexed: 04/12/2023] Open
Abstract
Driver fatigue is a contributory factor in approximately 20% of vehicle crashes. While other causal factors (eg, drink-driving) have decreased in recent decades due to increased public education strategies and punitive measures, similar decreases have not been seen in fatigue-related crashes. Fatigued driving could be managed in a similar way to drink-driving, with an established point (ie, amount of prior sleep) after which drivers are "deemed impaired". This systematic review aimed to provide an evidence-base for the concept of deemed impairment and to identify how much prior sleep may be required to drive safely. Four online databases were searched (PubMed, Web of Science, Scopus, Embase). Eligibility requirements included a) measurement of prior sleep duration and b) driving performance indicators (eg, lane deviation) and/or outcomes (eg, crash likelihood). After screening 1940 unique records, a total of 61 studies were included. Included studies were categorised as having experimental/quasi-experimental (n = 21), naturalistic (n = 3), longitudinal (n = 1), case-control (n = 11), or cross-sectional (n = 25) designs. Findings suggest that after either 6 or 7 hours of prior sleep, a modest level of impairment is generally seen compared with after ≥ 8 hours of prior sleep (ie, well rested), depending on the test used. Crash likelihood appears to be ~30% greater after 6 or 7 hours of prior sleep, as compared to individuals who are well rested. After one night of either 4 or 5 hours of sleep, there are large decrements to driving performance and approximately double the likelihood of a crash when compared with well-rested individuals. When considering the scientific evidence, it appears that there is a notable decrease in driving performance (and associated increase in crash likelihood) when less than 5h prior sleep is obtained. This is a critical first step in establishing community standards regarding the amount of sleep required to drive safely.
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Affiliation(s)
- Madeline Sprajcer
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
- Correspondence: Madeline Sprajcer, Central Queensland University, Appleton Institute, 44 Greenhill Road, Wayville, SA, 5034, Australia, Email
| | - Drew Dawson
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Anastasi Kosmadopoulos
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Edward J Sach
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Meagan E Crowther
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Charli Sargent
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Gregory D Roach
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
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10
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Cori JM, Wilkinson VE, Soleimanloo SS, Westlake J, Stevens B, Rajaratnam SMW, Howard ME. A brief assessment of eye blink drowsiness immediately prior to or following driving detects drowsiness related driving impairment. J Sleep Res 2022; 32:e13785. [PMID: 36478313 DOI: 10.1111/jsr.13785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/10/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022]
Abstract
Drowsy driving is a major cause of fatal and serious injury motor vehicle accidents. The inability objectively to assess drowsiness has hindered the assessment of fitness to drive and the development of drowsy driving regulations. This study evaluated whether spontaneous eye blink parameters measured briefly pre- and post-drive could be used to detect drowsy driving impairment. Twelve healthy participants (6 female) drove an instrumented vehicle for 2 h on a closed-loop track during a rested (8-10 h awake) and an extended wake condition (32-34 h awake). Pre- and post-drive, the participants completed a 5 min eye blink task, a psychomotor vigilance task (PVT), and the Karolinska sleepiness scale (KSS). Whole drive impairment was defined as >3.5 lane departures per hour. Severe end of drive impairment was defined as ≥2 lane departures in the last 15 min. The pre-drive % of time with eyes closed best predicted the whole drive impairment (area under the curve [AUC] 0.87). KSS had similar prediction ability (AUC 0.85), while PVT reaction time (AUC 0.72) was less accurate. The composite eye blink parameter, the Johns drowsiness scale was the best retrospective detector of severe end of drive impairment (AUC 0.99). The PVT reaction time (AUC 0.92) and the KSS (AUC 0.93) were less accurate. Eye blink parameters detected drowsy driving impairment with an accuracy that was similar to, or marginally better than, PVT and KSS. As eye blink measures are simple to measure, are objective and have high accuracy, they present an ideal option for the assessment of fitness for duty and roadside drowsiness.
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Affiliation(s)
- Jennifer M. Cori
- Institute for Breathing and Sleep, Austin Health Heidelberg Victoria Australia
- Department of Respiratory and Sleep Medicine, Austin Health Heidelberg Victoria Australia
- CRC for Alertness, Safety and Productivity Victoria Australia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University Clayton Victoria Australia
| | - Vanessa E. Wilkinson
- Institute for Breathing and Sleep, Austin Health Heidelberg Victoria Australia
- Department of Respiratory and Sleep Medicine, Austin Health Heidelberg Victoria Australia
- CRC for Alertness, Safety and Productivity Victoria Australia
| | - Shamsi Shekari Soleimanloo
- Institute for Breathing and Sleep, Austin Health Heidelberg Victoria Australia
- Department of Respiratory and Sleep Medicine, Austin Health Heidelberg Victoria Australia
- CRC for Alertness, Safety and Productivity Victoria Australia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University Clayton Victoria Australia
- Institute for Social Science Research, The University of Queensland Queensland Australia
| | - Justine Westlake
- Institute for Breathing and Sleep, Austin Health Heidelberg Victoria Australia
- Department of Respiratory and Sleep Medicine, Austin Health Heidelberg Victoria Australia
| | - Bronwyn Stevens
- Institute for Breathing and Sleep, Austin Health Heidelberg Victoria Australia
- Department of Respiratory and Sleep Medicine, Austin Health Heidelberg Victoria Australia
| | - Shantha M. W. Rajaratnam
- CRC for Alertness, Safety and Productivity Victoria Australia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University Clayton Victoria Australia
| | - Mark E. Howard
- Institute for Breathing and Sleep, Austin Health Heidelberg Victoria Australia
- Department of Respiratory and Sleep Medicine, Austin Health Heidelberg Victoria Australia
- CRC for Alertness, Safety and Productivity Victoria Australia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University Clayton Victoria Australia
- Department of Medicine, The University of Melbourne Parkville Victoria Australia
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11
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On-road driving impairment following sleep deprivation differs according to age. Sci Rep 2021; 11:21561. [PMID: 34732793 PMCID: PMC8566466 DOI: 10.1038/s41598-021-99133-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/06/2021] [Indexed: 11/08/2022] Open
Abstract
Impaired driving performance due to sleep loss is a major contributor to motor-vehicle crashes, fatalities, and serious injuries. As on-road, fully-instrumented studies of drowsy driving have largely focused on young drivers, we examined the impact of sleep loss on driving performance and physiological drowsiness in both younger and older drivers of working age. Sixteen ‘younger’ adults (M = 24.3 ± 3.1 years [21–33 years], 9 males) and seventeen ‘older’ adults (M = 57.3 ± 5.2, [50–65 years], 9 males) undertook two 2 h drives on a closed-loop track in an instrumented vehicle with a qualified instructor following (i) 8 h sleep opportunity the night prior (well-rested), and (ii) after 29-h of total sleep deprivation (TSD). Following TSD, both age groups displayed increased subjective sleepiness and lane departures (p < 0.05), with younger drivers exhibiting 7.37 × more lane departures, and 11 × greater risk of near crash events following sleep loss. While older drivers exhibited a 3.5 × more lane departures following sleep loss (p = 0.008), they did not have a significant increase in near-crash events (3/34 drives). Compared to older adults, younger adults had 3.1 × more lane departures (p = < 0.001), and more near crash events (79% versus 21%, p = 0.007). Ocular measures of drowsiness, including blink duration, number of long eye closures and PERCLOS increased following sleep loss for younger adults only (p < 0.05). These results suggest that for older working-aged adults, driving impairments observed following sleep loss may not be due to falling asleep. Future work should examine whether this is attributed to other consequences of sleep loss, such as inattention or distraction from the road.
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12
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Cori JM, Downey LA, Sletten TL, Beatty CJ, Shiferaw BA, Soleimanloo SS, Turner S, Naqvi A, Barnes M, Kuo J, Lenné MG, Anderson C, Tucker AJ, Wolkow AP, Clark A, Rajaratnam SMW, Howard ME. The impact of 7-hour and 11-hour rest breaks between shifts on heavy vehicle truck drivers' sleep, alertness and naturalistic driving performance. ACCIDENT; ANALYSIS AND PREVENTION 2021; 159:106224. [PMID: 34192654 DOI: 10.1016/j.aap.2021.106224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/01/2021] [Accepted: 05/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND An inadequate rest break between shifts may contribute to driver sleepiness. This study assessed whether extending the major rest break between shifts from 7-hours (Australian industry standard) to 11-hours, improved drivers' sleep, alertness and naturalistic driving performance. METHODS 17 heavy vehicle drivers (16 male) were recruited to complete two conditions. Each condition comprised two 13-hour shifts, separated by either a 7- or 11-hour rest break. The initial 13-hour shift was the drivers' regular work. The rest break and following 13-hour shift were simulated. The simulated shift included 5-hours of naturalistic driving with measures of subjective sleepiness, physiological alertness (ocular and electroencephalogram) and performance (steering and lane departures). RESULTS 13 drivers provided useable data. Total sleep during the rest break was greater in the 11-hour than the 7-hour condition (median hours [25th to 75th percentile] 6.59 [6.23, 7.23] vs. 5.07 [4.46, 5.38], p = 0.008). During the simulated shift subjective sleepiness was marginally better for the 11-hour condition (mean Karolinska Sleepiness Scale [95th CI] = 4.52 [3.98, 5.07] vs. 5.12 [4.56, 5.68], p = 0.009). During the drive, ocular and vehicle metrics were improved for the 11-hour condition (p<0.05). Contrary to expectations, mean lane departures p/hour were increased during the 11-hour condition (1.34 [-0.38,3.07] vs. 0.63 [-0.2,1.47], p = 0.027). CONCLUSIONS Extending the major rest between shifts substantially increases sleep duration and has a modest positive impact on driver alertness and performance. Future work should replicate the study in a larger sample size to improve generalisability and assess the impact of consecutive 7-hour major rest breaks.
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Affiliation(s)
- Jennifer M Cori
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia.
| | - Luke A Downey
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia
| | - Tracey L Sletten
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Caroline J Beatty
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Brook A Shiferaw
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia; Seeing Machines Ltd., 80 Mildura St., Fyshwick, ACT, Australia
| | - Shamsi Shekari Soleimanloo
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia; Institute for Social Science Research, The University of Queensland, Queensland, Australia
| | - Sophie Turner
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Aqsa Naqvi
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Maree Barnes
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, University of Melbourne, Australia
| | - Jonny Kuo
- Seeing Machines Ltd., 80 Mildura St., Fyshwick, ACT, Australia
| | - Michael G Lenné
- Seeing Machines Ltd., 80 Mildura St., Fyshwick, ACT, Australia
| | - Clare Anderson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Andrew J Tucker
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Alexander P Wolkow
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Anna Clark
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia; Department of Medicine, University of Melbourne, Australia
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13
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Cori JM, Manousakis JE, Koppel S, Ferguson SA, Sargent C, Howard ME, Anderson C. An evaluation and comparison of commercial driver sleepiness detection technology: a rapid review. Physiol Meas 2021; 42. [PMID: 34338222 DOI: 10.1088/1361-6579/abfbb8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/26/2021] [Indexed: 11/11/2022]
Abstract
Objective. Sleepiness-related motor vehicle crashes, caused by lack of sleep or driving during night-time hours, often result in serious injury or fatality. Sleepiness detection technology is rapidly emerging as a sleepiness risk mitigation strategy for drivers. Continuous monitoring technologies assess and alert to driver sleepiness in real-time, while fit for duty technologies provide a single assessment of sleepiness state. The aim of this rapid review was to evaluate and compare sleepiness detection technologies in relation to specifications, cost, target consumer group and validity.Approach. We evaluated a range of sleepiness detection technologies suitable for consumer groups ranging from regular drivers in private vehicles through to work-related drivers within large businesses.Main results. Continuous monitoring technologies typically ranged between $100 and $3000 AUD and had ongoing monthly costs for telematics functionality and manager alerts. Fit for duty technologies had either a one-off purchase cost or a monthly subscription cost. Of concern, the majority of commercial continuous monitoring technologies lacked scientific validation. While some technologies had promising findings in terms of their ability to detect and reduce driver sleepiness, further validation work is required. Field studies that evaluate the sensitivity and specificity of technology alerts under conditions that are regularly experienced by drivers are necessary. Additionally, there is a need for longitudinal naturalistic driving studies to determine whether sleepiness detection technologies actually reduce sleepiness-related crashes or near-crashes.Significance. There is an abundance of sleepiness detection technologies on the market, but a majority lacked validation. There is a need for these technologies and their validation to be regulated by a driver safety body. Otherwise, consumers will base their technology choices on cost and features, rather than the ability to save lives.
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Affiliation(s)
- Jennifer M Cori
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.,Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Jessica E Manousakis
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Sjaan Koppel
- Monash University Accident Research Centre, Monash University, Melbourne, Australia
| | - Sally A Ferguson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
| | - Charli Sargent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
| | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.,Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Department of Medicine, University of Melbourne, Australia
| | - Clare Anderson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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14
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Hidalgo-Gadea G, Kreuder A, Krajewski J, Vorstius C. Towards better microsleep predictions in fatigued drivers: exploring benefits of personality traits and IQ. ERGONOMICS 2021; 64:778-792. [PMID: 33538641 DOI: 10.1080/00140139.2021.1882707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/24/2021] [Indexed: 06/12/2023]
Abstract
Fatigued driving is one of the main contributors to road traffic accidents. Poor sleep quality and lack of sleep negatively affect driving performance, and extreme states of fatigue can cause microsleep (i.e., short episodes of sleep with complete loss of awareness). Driver monitoring systems analyse biosignals (e.g., gaze, blinking, heart rate) and vehicle data (e.g., steering wheel movements, lane holding, acceleration) to detect states of fatigue and prevent accidents. We argue that inter-individual differences in personality, sensation seeking behaviour, and intelligence could improve microsleep prediction, in addition to sleepiness. We tested 144 male participants in a supervised driving track after 27 hours of sleep deprivation. More than 74% of drivers experienced microsleep, after an average driving time of 52 min. Overall, prediction models for microsleep vulnerability and driving time before microsleep were significantly improved by conscientiousness, sensation seeking and non-verbal IQ, in addition to situational sleepiness, as individual risk factors. Practitioner summary: This study offers valuable insights for the design of driver monitoring systems. The use of individual risk factors such as conscientiousness, sensation seeking, and non-verbal IQ can increase microsleep prediction. These findings may improve monitoring systems based solely on physiological signals (e.g., blinking, heart rate) and vehicle data (e.g., steering wheel movements, acceleration, cornering). Abbreviations: ADAC: Allgemeiner Deutscher Automobil Club; ANOVA: analysis of variance; AIC: Akaike information criteria; CI: confidence interval; GPS: global positioning system; IQ: intelligence quotient; IQR: inter quartile range; KSS: Karolinska sleepiness scale; NEO-PI-R: revised NEO personality inventory; OLS: ordinary least squares; PSQI: Pittsburgh sleep quality index; SPM: standard progressive matrices; SSS: sensation seeking scale; WHO: World Health Organization.
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Affiliation(s)
- Guillermo Hidalgo-Gadea
- Department of General and Biological Psychology, University of Wuppertal, Wuppertal, Germany
| | - Annika Kreuder
- Institute for Experimental Psychology, University of Düsseldorf, Düsseldorf, Germany
| | - Jarek Krajewski
- Institute of Safety Technology, University of Wuppertal, Wuppertal, Germany
| | - Christian Vorstius
- Department of General and Biological Psychology, University of Wuppertal, Wuppertal, Germany
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15
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Stancin I, Cifrek M, Jovic A. A Review of EEG Signal Features and their Application in Driver Drowsiness Detection Systems. SENSORS 2021; 21:s21113786. [PMID: 34070732 PMCID: PMC8198610 DOI: 10.3390/s21113786] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 01/05/2023]
Abstract
Detecting drowsiness in drivers, especially multi-level drowsiness, is a difficult problem that is often approached using neurophysiological signals as the basis for building a reliable system. In this context, electroencephalogram (EEG) signals are the most important source of data to achieve successful detection. In this paper, we first review EEG signal features used in the literature for a variety of tasks, then we focus on reviewing the applications of EEG features and deep learning approaches in driver drowsiness detection, and finally we discuss the open challenges and opportunities in improving driver drowsiness detection based on EEG. We show that the number of studies on driver drowsiness detection systems has increased in recent years and that future systems need to consider the wide variety of EEG signal features and deep learning approaches to increase the accuracy of detection.
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16
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Eye blink parameters to indicate drowsiness during naturalistic driving in participants with obstructive sleep apnea: A pilot study. Sleep Health 2021; 7:644-651. [PMID: 33935013 DOI: 10.1016/j.sleh.2021.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To determine whether continuous eye blink measures could identify drowsiness in patients with obstructive sleep apnea (OSA) during a week of naturalistic driving. DESIGN Observational study comparing OSA patients and healthy controls. SETTING Regular naturalistic driving across one week. PARTICIPANTS Fifteen untreated moderate to severe OSA patients and 15 age (± 5 years) and sex (female = 6) matched healthy controls. MEASUREMENTS Participants wore an eye blink drowsiness recording device during their regular driving for one week. RESULTS During regular driving, the duration of time with no ocular movements (quiescence), was elevated in the OSA group by 43% relative to the control group (mean [95% CI] 0.20[0.17, 0.25] vs 0.14[0.12, 0.18] secs, P = .011). During long drives only, the Johns Drowsiness Scale was also elevated and increased by 62% in the OSA group relative to the control group (1.05 [0.76, 1.33] vs 0.65 [0.36, 0.93], P = .0495). Across all drives, critical drowsiness events (defined by a Johns Drowsiness Scale score ≥2.6) were twice as frequent in the OSA group than the control group (rate ratio [95% CI] =1.93 [1.65, 2.25], P ≤ .001). CONCLUSIONS OSA patients were drowsier than healthy controls according to some of the continuous real time eye blink drowsiness measures. The findings of this pilot study suggest that there is potential for eye blink measures to be utilized to assess fitness to drive in OSA patients. Future work should assess larger samples, as well as the relationship of eye blink measures to conventional fitness to drive assessments and crash risk.
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17
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Johns M, Hocking C. The effects of unintentional drowsiness on the velocity of eyelid movements during spontaneous blinks. Physiol Meas 2021; 42:014003. [PMID: 33352535 DOI: 10.1088/1361-6579/abd5c3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Unintentional drowsiness, when we should be alert, as for example when driving a vehicle, can be very dangerous. In this investigation we examined the effects of unintentional drowsiness on the relative velocities of eyelid closing and reopening movements during spontaneous blinks. APPROACH Twenty-four young adults volunteered to take part in this experiment, and 18 were finally accepted. They performed a 15 min visual reaction-time test at the same time of day and under the same environmental conditions with and without overnight sleep deprivation, one week apart. Their eyelid movements during blinks were monitored by a system of infrared reflectance blepharometry during each test. MAIN RESULTS Very close relationships between the amplitude and maximum velocity of eyelid closing and reopening movements were confirmed. Frequency histograms of amplitude-velocity ratios (AVRs) for eyelid closing and reopening movements showed significant differences between alert and drowsy conditions. With drowsiness, eyelid movements became slower and AVRs increased for many but not all blinks. We also described a time-on-task effect on the relative velocities of eyelid movements which was more apparent in the drowsy condition. Eyelid movements became progressively slower during the first half of the test. This was presumably due to a short-lived alerting effect of starting the test. SIGNIFICANCE The relative velocity of eyelid closing and reopening movements during spontaneous blinks decreases with unintentional drowsiness but is sensitive to the brief alerting stimulus of starting a reaction-time test.
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Affiliation(s)
- Murray Johns
- Optalert Australia Pty Ltd, 112 Balmain Street, Richmond, Melbourne, Victoria, 3121, Australia. School of Health Sciences, Swinburne University of Technology, Hawthorn, Melbourne, Victoria, 3122, Australia
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18
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Rizzo D, Baltzan M. An Objective Measure of Drowsy Driving: Are We There Yet? J Clin Sleep Med 2019; 15:1191-1192. [PMID: 31538587 PMCID: PMC6760413 DOI: 10.5664/jcsm.7954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 07/19/2019] [Accepted: 07/19/2019] [Indexed: 11/13/2022]
Abstract
CITATION Rizzo D, Baltzan M. An objective measure of drowsy driving: are we there yet? J Clin Sleep Med. 2019;15(9):1191-1192.
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Affiliation(s)
- Dorrie Rizzo
- Lady Davis Institute for Medical Research (Jewish General Hospital), Montreal, Canada
- McGill University, Montreal, Canada
| | - Marc Baltzan
- McGill University, Montreal, Canada
- Mount-Sinai Hospital, Montreal, Canada
- OSR Medical, Montreal, Canada
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